Stakeholder perspectives on research and development priorities for mobility assistive-technology: a literature review.

PURPOSE: Over one billion people with disabilities (PWDs) and older adults with mobility impairment are currently in need of assistive technology devices (ATDs) and only 10% of those population have ordinarily access to them. The need for advancement in mobility-assistive technology is growing to address the gap in ATDs provision globally. The purpose of this review is to identify potential future areas of development and research in mobility-assistive technology. METHOD: Publications were identified using scientific and medical electronic databases. Also, a limited grey literature search was conducted to muster a variety of sources. A combination of keyword search terms was used, corresponding to the medical subject heading (MeSH) terms. RESULTS: A total of 392 articles were identified, of which 75 were selected for detailed review. Twenty-eight articles were identified that met the review's inclusion criteria. Future areas of research for mobility-assistive technology were identified by grouping the publications into four main categories. The findings of this review identified several areas of research and development in ATDs in general and mobility-assistive technology, in particular, with special attention to the importance of engaging users and stakeholders in the process of research and design. CONCLUSIONS: It is apparent that users' needs and priorities vary between regions within countries. The majority of studies were noted to mainly identify consumers' perspectives on a national basis. The authors, therefore, suggest that further research should be conducted on a global level to determine the knowledge and perspectives concerning future research and development needs and priorities in mobility-assistive technologies.Implication for RehabilitationDespite the benefits derived from the use of ATDs, only 10% of people with disabilities have access to them.Increasing access, quality and affordable ATDs in all countries is global demand.Identifying mobility consumers' needs and priorities would help in enhancing their quality of life by translating research into new technologies that meet their environment and culture needs.Users' involvement in research and design process is a crucial approach to re-shape the future research agenda.

Development of a wheelchair maintenance training programme and questionnaire for clinicians and wheelchair users.

Purpose of state: The aims of this study were to develop a Wheelchair Maintenance Training Programme (WMTP) as a tool for clinicians to teach wheelchair users (and caregivers when applicable) in a group setting to perform basic maintenance at home in the USA and to develop a Wheelchair Maintenance Training Questionnaire (WMT-Q) to evaluate wheelchair maintenance knowledge in clinicians, manual and power wheelchair users. METHODS: The WMTP and WMT-Q were developed through an iterative process. RESULTS: A convenience sample of clinicians (n = 17), manual wheelchair (n ∞ 5), power wheelchair users (n = 4) and caregivers (n = 4) provided feedback on the training programme. A convenience sample of clinicians (n = 38), manual wheelchair (n = 25), and power wheelchair users (n = 30) answered the WMT-Q throughout different phases of development. The subscores of the WMT-Q achieved a reliability that ranged between ICC(3,1) = 0.48 to ICC(3,1) = 0.89. The WMTP and WMT-Q were implemented with 15 clinicians who received in-person training in the USA using the materials developed and showed a significant increase in all except one of the WMT-Q subscores after the WMTP (p < 0.007). CONCLUSION: The WMTP will continue to be revised as it is further implemented. The WMT-Q is an acceptable instrument to measure pre- and post-training maintenance knowledge. Implications for Rehabilitation The Wheelchair Maintenance Training Program can be used to educate rehabilitation clinicians and technicians to improve wheelchair service and delivery to end users. This training complements the World Health Organization basic wheelchair service curriculum, which only includes training of the clinicians, but does not include detailed information to train wheelchair users and caregivers. This training program offers a time efficient method for providing education to end users in a group setting that may mitigate adverse consequences resulting from wheelchair breakdown. This training program has significant potential for impact among wheelchair users in areas where access to repair services is limited.

Type and Frequency of Reported Wheelchair Repairs and Related Adverse Consequences Among People With Spinal Cord Injury.

OBJECTIVE: To investigate the frequency and types of wheelchair repairs and associated adverse consequences. DESIGN: Convenience cross-sectional sample survey. SETTING: Nine Spinal Cord Injury Model Systems Centers. PARTICIPANTS: People with spinal cord injury who use a wheelchair >40h/wk (N=591). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Number of repairs needed and resulting adverse consequences, number and types of repairs completed, and location where main repair was completed in the previous 6 months. RESULTS: There were 591 participants responded to the survey, 63.8% (377/591) of them needed ≥1 repair; of these, 27.6% (104/377) experienced ≥1 adverse consequence, including 18.2% (69/377) individuals who were stranded. Of those who needed repairs, 6.9% did not have them completed (26/377). Repairs completed on the wheels and casters were the most frequent repair to manual wheelchairs, whereas repairs to the electrical and power and control systems were the most frequent type of repair on power wheelchairs. Forty percent (79/201) of manual wheelchair users reported completing repairs at home themselves compared with 14% (21/150) of power wheelchair users. Twelve percent of the variance in the odds of facing an adverse consequence because of a wheelchair breakdown can be described as a function of occupation, funding source, and type of wheelchair. CONCLUSIONS: Wheelchair repairs are highly prevalent. There are differences in types of repairs and who completes the repairs based on the type of wheelchair. Wheelchair breakdowns result in adverse consequences for users, and there is a deficit between repairs needed and those completed, highlighting the need for interventions that address these problems.

The impact of transfer setup on the performance of independent wheelchair transfers.

OBJECTIVE: The aim of this study was to determine how selected environmental factors affect transfers and to compare our results to the Americans with Disabilities Act Accessibility Guidelines (ADAAG). BACKGROUND: Few data are available to support standards development related to transfers in the built environment. METHOD: Participants were 120 wheeled mobility device (WMD) users who transferred to and from a modular transfer station that consisted of a height-adjustable platform with a lateral grab bar, optional obstacle to the transfer, and an optional height-adjustable front grab bar. Maximum and minimum vertical heights of the transfer surface, maximum gap distance between the WMD and transfer surface, grab bar use, and WMD space needs were recorded. RESULTS: The 95th percentile lowest and highest heights attained were similar to the median WMD seat-to-floor height (56 cm).We found that 42% (47/113) could not perform a transfer with the obstacle present. Participants transferred higher when the front grab bar was added to the setup (p = .005) and higher and lower with the front grab bar than without it when the obstacle was present in the setup (p = .003 and p = .005, respectively). We found that 95% of participants performed a transfer across an 8.9-cm gap. ADAAG recommendations fall short for the height and clear-space needs of the 50th-percentile WMD users. CONCLUSION: Revisions concerning transfer heights, gaps, clear spaces, and grab bar heights are necessary to make transfers more accessible to WMD users. APPLICATION: The data will be used to revise the guidelines related to transfers and to enable designers and engineers to create an environment that is more accessible.

Detección, rastreo y reconstrucción tridimensional de marcadores pasivos para análisis de movimiento humano. Cinemed III / Detection, tracking and 3D reconstruction of passive markers for human gait analysis

Uno de los desafíos más importantes cuando se desarrolla un sistema de análisis de movimiento es la reconstrucción tridimensional, ya que este proceso involucra una serie de algoritmos que tienen que trabajar de forma sinérgica con el fin de reconstruir el movimiento correctamente y aminorando el número de intervenciones del usuario. Por esta razón en este artículo, se realiza una descripción detallada de un esquema para la reconstrucción tridimensional del movimiento humano mediante la integración de diferentes algoritmos que a su vez minimizan la intervención del usuario durante el proceso (Sistema de análisis de movimiento CineMED II). Para probar el desempeño del esquema propuesto se realizaron tres pruebas experimentales; un marcador estático, barra con dos marcadores en movimiento y dispositivo de medición de errores. Obteniendo finalmente que CineMED II posee un desempeño cercano al de los sistemas comerciales, mostrando en las pruebas realizadas con la barra un error absoluto medio menor respecto al sistema Vicon, pero mayor con respecto al sistema Elite y en las pruebas con el dispositivo un valor de RMS mayor respecto al sistema Ariel, pero un error máximo menor respecto a este ultimo sistema, sin embargo la aproximación propuesta presenta problemas cuando se ocluyen marcadores por largos periodos de tiempo y cuando se cruza la trayectoria de dos marcadores. Para resolver dichos problemas se propone adicionar algunas cámaras al sistema y así obtener información redundante de la captura del movimiento

One of the most important challenges when a movement analysis system is been developed is the three-dimensional reconstruction. This process involves several algorithms that must work synergistically in order to reconstruct the movement correctly and decreasing the user interventions. For this reason this paper describes in detail a new methodology to carry out the three-dimensional reconstruction of the human movement through the join of different algorithms decreasing the user input during the process (movement analysis system CineMED II). To analyze and evaluate the performance achieved using the methodology proposed, three experimental tests were carried out; a static marker test, bar with two markers in motion and using an error measurement device. CineMED III finally has a performance close to that of commercial systems, showing in the tests performed with the bar a lower average absolute error for the Vicon system, but higher with respect to the Elite system and testing the device with a value of RMS more about the Ariel system, but a smaller maximum error on the latter system. However, the proposed approach presents problems when markers are occluded for long periods of time and when the paths of two markers intersect. To solve these problems, it is proposed to add some cameras into the system to obtain redundant information from the motion capture